No Surprises Act and Texas Medical Association

A federal appellate court has affirmed a lower court ruling that the manner in which federal regulations tell No Surprises Act dispute arbiters to evaluate competing fee claims unfairly favors health care payers over providers. At issue is a regulatory directive that arbiters weigh what is known as the qualifying payment amount – the median of what insurers contract to pay providers in a given geographic area – when deciding on payments.  In February a federal court ruled that using this measure in what is known as the independent dispute resolution process unfairly stacked the arbitration process in favor of [...]